Does the supplementation of the formula with fibre increase the risk of gastro-oesophageal reflux during enteral nutrition? A human study

Background & Aims: Fibre-supplements in enteral feeding could increase the risk of gastro-oesophageal reflux (GOR). The aim of this study was to asses s in humans the physiological effects of the supplementation of the enteral diet with different types of dietary fibre on gastro-oesophageal reflux ep isodes, gastric acidity and gastric emptying. Methods: pH profiles were com pared in 12 healthy volunteers between three different formula (500 kcal, 2 50 mL.h(-1)) delivered in a random order and containing either no fibre, ei ther soy polysaccharide fibre only or mixed fibre from pea and inuline. Ent eral diets were instilled through a nasogastric tube. Oesophageal and gastr ic pH recordings were combined with the ultrasound measurement of gastric a ntral area during the infusion. Results: More GOR were observed with a fibr e-free diet (median 4, range 1-10) than with a mixed (median 1.5, range 0-5 ) (P = 0.04) or soy polysaccharide fibre (median 1.5, range 0-5) (P = 0.04) diet. The median duration of GOR was longer with the mixed fibre (median 3 .6, range 1.8-7.2) than with the fibre-free diet (mean 1.8 min, range 1-3.6 ) (P < 0.05). The number of GOR episodes lasting more than 5 min, the durat ion of the longest GOR and the percent of time under pH 4 were not signific antly different with the three diets. The intragastric pH profile and the u ltrasound antral area were not different with all three diets. Conclusions: Addition of fibre to the enteral formula had limited effects on the onset of GOR episodes. It decreased the number of GOR but increased their duratio n. These effect were more pronounced with the formula containing soluble fi bre. At variance, the addition of fibre had no significant effect on gastri c emptying and gastric acid secretion. (C) 2001 Harcourt Publishers Ltd.